Posts for: April, 2015
Although normally benign, a cold sore outbreak can be irritating and embarrassing. Understanding why they occur is the first step to minimizing outbreaks.
The typical cold sore (also known as a fever blister) is caused by the Herpes Simplex Virus (HSV) Type I, medically known as “Herpes Labialis” because it occurs on or around the lips. This virus is not to be confused with HSV Type II, which causes a genital infection. Unlike most viruses, HSV Type I can cause a recurring sore outbreak in certain people. Most viruses tend to occur only once because the body produces anti-bodies to prevent further attack; it’s believed HSV Type I, however, can shield itself from these defenses by hiding in the body’s nerve roots.
These cold sore outbreaks often occur during periods of high stress, overexposure to sunlight or injuries to the lip. Initially you may have an itch or slight burning around the mouth that escalates into more severe itching, redness, swelling and blistering. The sores will break out for about a week to ten days and then scab over and eventually heal (unless they become infected, in which case the healing process may go longer). You’re contagious between the first symptoms and healing, and so can spread the virus to other people.
In recent years, anti-viral prescription medications have been developed that can effectively prevent HSV outbreaks, or at least reduce the healing time after an occurrence. The most common of these are acyclovir and valcyclovir, proven effective with only a few possible mild side effects. They can be taken routinely by people with recurring cold sores to suppress regular outbreaks.
While HSV Type I cold sores are more an aggravation than a health danger, it’s still important for you to see us initially for an examination if you encounter an outbreak. It’s possible for a more serious condition to masquerade as a cold sore or blister. A visit to us may also get you on the right track to reducing the frequency of outbreaks, as well as minimizing discomfort when they do occur.
If you would like more information on the treatment of cold sores, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Cold Sores.”
Even after decades emphasizing oral hygiene and supplemental fluoride to fight dental disease, we’re now seeing an increase in tooth decay, especially among children. What’s causing this alarming trend?
Many in both the dental and medical professions link this and other health problems to a rise in the amount and consumption of sugar added to food products. A number of years ago our annual average consumption of added sugar was about 4 pounds per person; today, it’s closer to 90 pounds.
The increase in sugar consumption can be traced to the 1970s when the food industry began adding more sugar to make processed foods stripped of oils and fats taste better. Today, 77% of the approximately 600,000 food items sold in the United States contain some form of sugar (under a variety of names).
This additional sugar, however, has produced an unintended consequence: sugar triggers the release of a brain chemical called dopamine that regulates our sense of reward when we engage in a desirable behavior. The excess dopamine creates a weak addiction to sugar, which then leads to overconsumption, contributing to our current obesity epidemic and the rise in health problems like heart disease or Type 2 diabetes. This is especially alarming among children: thirty years ago Type 2 diabetes was unheard of among children — today there are over 55,000 diagnosed pediatric cases.
For both you and your family’s general and dental health, you should consider ways to reduce your sugar intake: purchase and eat most of your food from the “outer edges” of your supermarket — meats, dairy, and fresh vegetables and fruits (which do contain the sugar fructose, but are mostly fiber that slows the liver’s processing of the sugar); limit processed foods with added sugar, and learn to recognize its inclusion in products by reading ingredients labels. You should also be wary of sweetened beverages such as sodas, sports drinks, teas or juices, and try to drink more water.
The recommended daily sugar consumption is less than six teaspoons a day (about two-thirds the amount in one can of soda). By restricting this consumption, you’ll improve your general health and reduce your risk for dental disease.
Besides reduced biting and chewing function, a missing tooth can cause an embarrassing inhibition to healthy social interaction. This can be especially so for teens who greatly value peer relationships and acceptance.
Be that as it may, we typically discourage a permanent replacement for teens with a missing tooth, particularly dental implants. While we value a patient’s psychological needs, the long-term effect on dental health may be too great to advise otherwise.
The effect we’re concerned with involves jaw growth and development. Although a person’s permanent teeth have usually all erupted by early adolescence, the jaws continue to grow until the late teens or early twenties. Natural teeth can adapt to this growth because the periodontal ligament that holds them in place allows for incremental tooth movement. The teeth move in response to jaw growth and are thus able to maintain their proper relationship and alignment in the jaw as growth occurs.
Dental implants, on the other hand, are imbedded into the jaw bone: they, therefore, can’t move like natural teeth and thus can’t adjust their position with jaw growth, particularly the upper jaw as it grows forward and down. This can result in the implants appearing as though they are left behind or retreat into the jaw. It can also affect the position of the gums and inhibit their growth around the implants.
It’s best then to hold off implants and other permanent restorations until the jaw has finished developing. That, however, isn’t always easy to determine: specialized x-ray diagnostics may help, but it’s not an exact science. Your input as a parent will also be helpful, such as whether you’ve noticed the end of growth spurts (not changing clothes or shoe sizes as often) or your child’s recent similarity in appearance to other adult members of your family. It thus becomes a judgment call, based on examination and experience, as to whether it’s safe to proceed with implants — and may require erring on the side of caution.
In the meantime, there are temporary restorations that can improve appearance while you wait for the appropriate time to undertake a permanent restoration. Two of the most useful are removable partial dentures (RPDs) or a bonded bridge, a less invasive form of the traditional bridge. With a proper assessment we can advise you on which option is your best choice.
If you would like more information on tooth restorations for teenagers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teenagers & Dental Implants.”
Oral cancer is a serious health problem, responsible for the death of about one person every hour, every day in the United States. It was once thought that folks over 40 were chiefly at risk for the disease. If present trends continue, however, younger people may soon form the majority of oral cancer patients. So, no matter who you are, it makes sense to recognize the risk factors, and find out what you can do to reduce your chances of getting the disease.
As in many other diseases, genetic factors play a role in determining whether an individual will develop oral cancer. At present, there's nothing we can do about these inborn traits. But there are several choices we can make that will lessen our risk of oral cancer. Most of these risky behaviors are associated with other types of cancer as well.
Moderate to heavy drinkers, and users of tobacco products of all types, are as much as 9 times more likely to develop the disease than non-users. Chronic exposure to the sun has long been associated with the development of cancers of the lip. And, because the sexually-transmitted Human Papilloma Virus (HPV) can lead to oral cancer, unsafe sexual behavior is a factor that's fast becoming a primary cause of the disease.
So if you need another reason to quit smoking, stop drinking excessively, wear sunscreen and practice safe sex — consider this your warning. But there's still more you can do to reduce your risk for oral cancer, and improve your general health as well.
Eating a plant-based, whole food diet doesn't just reduce your risk of getting oral cancer — it also makes you less likely to develop many other cancers, and various chronic conditions like heart disease. The exact mechanisms by which this happens aren't completely understood, but its effects have been documented in numerous studies.
Avoiding certain chemicals, like the nitrites often found in preserved foods, can reduce cancer risk. And the antioxidants you get by eating a balanced diet rich in fruits and vegetables can help protect your body from cancer-causing substances.
Finally, don't ignore regular cancer screenings. The early signs of oral cancer are difficult for many people to distinguish from common mouth sores — but we are trained to identify possible problem areas, and can schedule further tests if needed. You can get an oral cancer screening (a fast and painless procedure) at your regular dental checkup. And you always get your checkups on time — don't you?
If you have concerns about oral cancer, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Oral Cancer” and “Diet and Prevention of Oral Cancer.”